What is a Trauma-Informed Therapist?

What’s this buzzword “trauma-informed” mean? Trauma-informed means that the therapist has been trained to see client behaviors as symptoms of trauma, instead of as dysfunction.

Why is being trauma-informed useful? Understanding things from a trauma perspective allows a therapist to view the client as a whole person from the angle of trauma, with the behaviors as a function of trauma, as a means to an end, a repeating of negative patterns, a way they adapted to their environment. It allows the therapist to see the client outside of negative labels such as: willful, inappropriate, manipulative, or staff-splitting. This is especially useful for people who have developed personality disorders like borderline personality disorder. Seeing clients differently allows us to act differently and treat the behaviors with more care and usefulness.

Trauma-Informed vs. Trauma Specialist Is a trauma-informed therapist the same as a trauma specialist? No. There has been a big push to get therapists trained in trauma-informed care over the past 5 years or so, which is wonderful. This often consists of a single introductory-level training which may be only a couple of hours. A trauma specialist, by contrast, has been training in trauma-related treatments for at least dozens of hours, generally over many years. Personally, I have trained hundreds of hours over a decade in various trauma-related treatments over a decade.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Overwhelmed? Obsessing? A technique for you.

several plants in pots along a sunny windowsill

Zooming in/out

When I am overwhelmed, like thinking about war and climate change and politics, global issues that I have little to no control over, I am zoomed too far out. I’m looking at life through a telescope. I’m needing to change the focus to what is now, here in front of me, that I can change or have control over.

When I’m obsessing, like thinking about day-to-day stressors and my to-do list and all the little pieces that seem to need my attention, I am zoomed too far in. I’m looking at life through a microscope. I’m needing to change the focus to what is now, that I can accomplish and check off, that I can move in the priority if necessary.

I challenge you to change your focus. Notice if you are zoomed too far in or out, and move to a more comfortable middle ground. This is a skill and takes practice, so assume that the lens is going to get out of focus sometimes, and that’s okay, but it is also adjustable and you have the ability to adjust it to be comfortable for you.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

What Does the “Don’t Say Gay” Bill Mean for School Counselors

boy sitting cross-legged, wearing goggles and a hat, making airplane arms, with wooden toy of plane next to him

On March 8, 2022, new legislation was enacted by the Florida Senate by means of House Bill 1557: Parental Rights in Education that will go into effect July 1, 2022. According to the bill, parents and guardians are the ones who shall remain in control of what dialogue their child has in regard to sexual orientation and gender identity, and no school personnel should engage in these discussions as it may interfere with what the family chooses for the child to know/think.

According to the law school counselors follow, counselors do not have to report things to a parent or guardian if the child may be in danger by their reporting. For example, if a child reported abuse by a parent, the counselor is required by law to report that information to the Child Abuse Hotline, but do not have to tell the parent they are making a report. The bill itself states “This subparagraph does not prohibit a school district from adopting procedures that permit school personnel to withhold such information from a parent if a reasonably prudent person would believe that disclosure would result in abuse, abandonment, or neglect…” (section 8c2).

In many homes, a gay or transgender child would be in danger if the parent or guardian was aware of their true nature, so students often hide who they are at home to keep the peace, and express themselves more freely at school. Many schools have become safe havens, allowing children to use their preferred names and pronouns.

What does this law mean for these children, now?

It is useful to delineate that this bill applies only to children in grades K-3 (section 8c3). At those ages, most children do not know their sexual orientation or gender identity, but some will. The bill wants the family to be the primary source of information at these young years and to steer the child in the direct they feel is most appropriate. Of course, there are those families that will use fundamental religion as a weapon against children who are not both heterosexual and cisgender, and this bill does give them the express right to do so.

There was fear around this bill before it was in its final form (as linked in the first paragraph above) that a homosexual teacher could be fired for answering the question “What did you do this weekend?” with “I went to the movies with my wife,” when a heterosexual teacher would have no consequences for saying the exact same thing. However, the bill states that students shall not have “classroom instruction…on sexual orientation or gender identity…that is not developmentally appropriate.” I read this as: it is absolutely developmentally appropriate to say “families look lots of different ways – some people have 1 parent or 2, or grandparents or aunts and uncles who live in the home, some have siblings or none, some have 2 moms or a mom and dad…” even at the Kindergarten level. In fact, I’m certain Sesame Street must have taught me this (and it did: Here and Here and Here and Here). Will a child get in trouble, or be hushed if she says she has 2 dads? No. This is developmentally appropriate.

Will a school counselor have to call the parent when a child says they think they have the wrong body and want to talk about it? Not necessarily, but maybe. Since this bill states that parents are to be kept in the know about what is going with their child, to be “notified about a change in his or her student’s [healthcare] services” (section 8c5), it would be prudent for the counselor to notify the family that the counselor met with the student at the child’s request and the child brought up certain issues or concerns. In this meeting, the counselor would be advised, according to this bill, to remain neutral, teach the child to remain calm, and suggest the child speak to their family about the matter. However, if the child expressed that they would be “abused, abandoned, or neglected” as a result of telling the family, the counselor would be wise to make a note of how the child expressed this, what they presented as the issue, how the counselor responded, and what the session consisted of; this protects the counselor in case the issue ever goes to court.

If the child is in the 4th grade or above, no change needs to take place. Children in progressive schools that have created the kind of safety that allows for use of their preferred name and pronouns can still employ those practice. Schools with a Safe Club that allows kids to express themselves and their feelings and thoughts around sexuality and gender can still hold those meetings. However, it would be best if those meetings were run by the students, for the students, and not led by a staff member, but overseen by a staff member; this ensures that it is not seen as the children being indoctrinated by anyone with an ulterior motive.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Multiple State Licenses

Autumn Hahn, Licensed Mental Health Counselor, Licensed Professional Counselor, Certified Clinical Hypnotherapist

There is a lot of confusion when it comes to getting licensed in multiple states. How do I begin? What is it called? What’s the benefit? I’ll demystify some of that here. I am licensed in Florida, my primary state, and state of residence, since 2010. I got licensed in Georgia in 2021, and have licenses pending in Washington DC and New York.

Why get licensed in multiple states?

The more states I am able to see clients in, the more business I stand to get. I accept insurance, and utilize a number of referral sources to get clients (if you are interested in information on those, please email me and I’ll refer you).

Having a wider base allows me to see the clients who are the most appropriate fit for my specialty. I specialize in trauma, and typically work with only those clients, so I don’t see everyone who needs therapy, only those who seek me out.

Working in multiple states allows me to serve a wider population. Being in telebehavioral health (seeing clients by video) allows me to serve clients in underserved areas, across the entire state.

The American Counseling Association is working on an Interstate Compact that will allow us to practice across state lines for those states participating in the compact, provided you are licensed in one of those states. The American Psychiatric Association has something similar for psychiatrists. You can learn more about the Compact here.

What are the types of license across states?

License by reciprocity – This is outdated. I have heard rumors that some states used to let you practice across state lines simply because you held a license in your state of origin. This is not true now, with the exception of some ability to do so during the pandemic. Do not pursue this. Even if you find it is true for some pandemic-related rules, it will go away at some point soon, if it hasn’t already. This is not a modern law or rule.

License by endorsement – This is your search criteria. If you want to become licensed in another state, search “License by endorsement counselor [state]” and follow the rules on their webpage. You may find that you need to have been licensed for a certain amount of years in your state of origin to qualify (in New York, for example, you have to be licensed for 5 years to qualify), or there may be other rules related to how many practicum hours you need to have completed, certain coursework your school needed to provide you, etc. You may also have to take an additional continuing education course to qualify; New York has a 2 hour child abuse awareness and reporting course everyone has to take. Complete the paperwork and send in your fee. Be aware that you will need access to: your unofficial transcript, your employment and education history, your existing license(s), professional references, and will likely have to send official transcripts, may have to get finger prints done, and more. The process varies by state. The verification and licensing process also varies by state. Georgia, for example, took less than 6 weeks to process all of my information and approve my license. DC, however, has had my paperwork for over 3 months and it is still “pending” with no reason given.

Your title may change as you apply across state lines. I am a Licensed Mental Health Counselor in Florida, but my title in Georgia is Licensed Professional Counselor. It is the same information, same degree, same everything, but certain states have different titles. It does not functionally mean or change anything.

Now what?

Once your secondary (or more) license has been approved, do a couple of things:

Update your referral sources to reflect the new status so you can begin advertising to those states. This includes your Psychology Today profile, website, email signature (mine says I am accepting clients in Florida and Georgia), and any paid referral sites that send you clients where you have a profile.

Go to your CE tracker and enter the new information so you can log all your appropriate CEUs and be certain you don’t miss any renewal dates. Make a note in your calendar to take a course that you need, as appropriate. I use CEBroker for Florida and CEWindow for Georgia.

I hope this information was helpful to you!

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

ADHD in Adults and My Experience

October is ADHD-Awareness Month. I thought I’d speak to my experience.

I was diagnosed with ADHD in my 40s. Looking back, I see the early symptoms in my childhood – lots of daydreaming, easily distracted, unable to have single-focus. I was raised in the kind of home where manners were important and was taught to pay attention, entertain myself in quiet situations (like in a restaurant), and respect my elders and others. This meant I always had a book with me so I had something to occupy my mind, did not interrupt, waited my turn, and adhered to all of the social niceties. Interrupting, getting out of your seat, and being loud or messy are symptoms of ADHD in children, especially boys, that I did not display because I was taught that they were unacceptable behaviors. But when I think back to being in school, I remember looking out of the window for long periods of time, doodling in the margins of my notes, writing poems during class lectures, and other distractible behaviors that were unnoticed by others. In college, I applied the behaviors I learned growing up; I had good study skills and was always a straight-A student. College was not difficult for me, but did require a lot of reading and studying outside of class.

As an young adult, I had learned to make my brain work for me. I multi-tasked constantly and always had 15 tabs open in my brain’s computer, including one always playing music of some sort. Working in an office was fine for me, but keeping to a clock always bothered me. I’m super-efficient, and get a job organized in just a few months and am bored thereafter. I hate punching a clock and find that I have usually finished my 8 hours of work in a few hours, so why be chained to the desk before I’m allowed to leave? This caused me to feel resentment and I thought there was something wrong with how I thought about work, as people I talked to did not feel this way, and simply slacked off more during the day; I would rather slack off at home, where my video games were. I always worked and attended school, as well as raised my kid, was in a relationship, and managed both my home and my kid’s extra-curricular activity. I was so busy outside of work, that having down time at work felt unacceptable.

In my later adulthood and career, I own and run multiple businesses, write books, play and run D&D games, am always planning business ideas, and all the normal things like see my friends and do hobbies. This works much better for me. I set my own schedule, can work a few hours here and there, jump from project to project, and utilize lists to get multiple things done. I use the calendar to set up my tasks and be sure they are done; I live and die by my calendar. I have used the Sticky Notes app on my computer, with a different note for each “category” (each business, home things, writing) to stay organized.

In my 40s, I went to the psychiatrist and asked about being assessed for ADHD. He asked me for a list of my current projects and I told him to clear out his calendar for the rest of the day. I listed them (take a deep breath): 3 projects for my board-game business in various stages of readiness, building my counseling business (including counseling, seeing interns, doing the social media, marketing, bookkeeping, etc.), planning auditing as a service, writing a curriculum for treatment centers, planning online courses to sell, and writing a fiction novel. He did some testing and prescribed me a medication. I’ve been on it since, including a dose increase. It took about a month before I noticed the change I was looking for: decreased distractibility. I want to finish more projects, spend more time on a project once I’ve begun it, and be more satisfied with the work that I am doing. Medication has helped me with this focus.

Here are a few of my favorite videos on how ADHD symptoms present in adults, and they’re in bite-sized format, perfect for the mind that has trouble concentrating.

https://vm.tiktok.com/ZMdYrE9K1/

https://vm.tiktok.com/ZMdYrgHAD/

https://vm.tiktok.com/ZMdYrKkXL/

https://vm.tiktok.com/ZMdYrKbeD/

https://vm.tiktok.com/ZMdYh6Exv/

https://vm.tiktok.com/ZMdYrKDx8/

https://vm.tiktok.com/ZMdYhjUrD/

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Suicide Can Wait

It’s okay if all you do today is survive.

Vineyard with hills in the background

If you are considering ending your life, do nothing for 24 hours. That is an accomplishment you can build upon. Avoiding an action is an action. 

How many small moments will you have today? Spend a little time outside, or just looking outside from inside. What do you notice? What made you smile, surprised, or captured your attention? What thoughts did you have? Those are the everyday moments that make life interesting. Share them with someone. What did they say? Did they share your feeling? What did they say? Those connections make life a shared experience. 

At this moment, it may be difficult, or even impossible, to see a life that doesn’t look like the one you have. But the experience of life is not constant and situations will change. Some may deteriorate and some may strengthen, but it is certain there will be change. Think of your life before it was how it feels now; maybe that was a year ago, or 5 or 10 years ago, but it was different. You haven’t always felt this badly. You won’t always feel this way, either. But it can take time. That might feel heavy to hear, but compare that other time to this one. Now compare this time to 1, 5, 10 years from now, even if may be difficult to imagine, know that it will be changed. You have to stick it out, get through this rough part to get to that good part again. 

This is a valley surrounded by hills. Keep climbing.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

The Benefits of Not Using your Insurance

Most people believe that going to therapy is a process earmarked by privacy. And it is, sort of, if you don’t use your insurance. I have worked in therapy both as a therapist and as a medical biller for a therapy agency, so I know both sides of this fence intimately. When you see your therapist, the therapist, by law, generates an intake, a treatment plan, and notes. They likely also diagnose you with one or more conditions, which may be transient or permanent, depending on the client.

If you use your insurance, this information is all available to the insurance company, and is part of the contract either your therapist or their agency signs when agreeing to be paid by the insurance company. The insurance company can reject payment if they do not have “justification” that your problem is significant enough, which can result in a therapist making an addendum to the note to state you are worse off then you are, or that they require more information about your case; this results in the therapist sending more information from your file (extra copies of notes or additional notes or summaries) stating your problem, when it began, problems with treatment (perhaps you missed an appointment, were late, or did not do a homework assignment), or additional facts about your case that were not initially captured in the session note. While, ethically, all of this information should be factual, it is also private and is not the business of the insurance company.

If you are seeking treatment for substance abuse, for example, it needs to be cited what drugs you were taking, but what means, in what amounts, for how long, and what previous steps you have taken to try and quit. If you have not tried unsuccessfully to quit on your own, most insurance companies will not cover your inpatient services. If you have tried to quit several times through inpatient and outpatient services, they may deny you as too big of a risk for failure. The insurance company is not on your side in these matters, but looks at you as part of risk-analysis.

I believe the client-therapist relationship is one based on honesty, privacy, ethics, and rapport. I want my clients to know that their information stays with me and no one else. I do not believe that most people understand how their information will be used and to whom and how it will be disclosed. Now you know. Feel free to share this.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Consultation: Write Better Notes

After a session, we are taught to write brief, but “good” notes. What does that even mean? Notes should take you 5-10 minutes to write. They should include a mini-mental status exam, what you did, how the client responded, and what you will do for next time.

I have streamlined this process and can teach you to do them quickly and well. My notes have gone through subpoena and I have been an expert witness with excellent results based on my notes.

Consultation is offered individually or in small groups and I am happy to work with your agency or group of interns. Cost is $100/hour and is estimated to take 1-2 hours. I am also happy to customize a training for you on what to include/exclude, working with specialty populations, treatment planning, and more. Please call to schedule an appointment at 954-612-9553.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

For the Sheer Joy of Doing it

Have you heard the expression “for the sheer joy of doing it”? As in: Look at that kid skipping down the sidewalk, just for the sheer joy of doing it.

Halloween child friendly treats with bananas and clementines made to look like pumpkins and ghosts

When is the last time you did something just for fun? Now take it even deeper. When is the last time you did something just for the sheer joy of doing it? I do lots of things for fun, but is it for joy? I thought about this for a couple of weeks and found that one thing I do for the sheer joy of doing it is dancing. Most of my hobbies are enjoyable, but don’t bring me joy. Perhaps I need more hobbies, or more dancing in my life.

What do you need more of, or to start doing?

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.

Reframing Guilt in Faith

I once worked with a Catholic woman in her 40s who felt that her history of serial monogamy had ruined her desire of dating in the future because it was in the way of her relationship with God. She felt that her four 5-year relationships were “failed” as they were all ended, and she did not know if she would or should ever date again as a result. She was erroneously linking past relationship with future relationships as if a pattern existed, and that it was a repetitive fractal.

We began with reframing the thought of “failed” versus “ended.” There were good things about the relationships that made each of them last for many years. There were also things about them that were not so good that made them worth ending. I challenged her belief that just because something doesn’t last forever, it does not mean it was failed. After all, she does not have the same job now that she had in high school. She agreed and it clicked. 
She responded “it must be the Catholic guilt.” I asked what was “Catholic” about guilt? She told me that, in her understanding, you are supposed to be with someone forever. I asked if she meant her first crush or the boy she lost her virginity to? She laughed again. “Well, neither…”
I asked her about her concept of God in order for her to envision her deity exactly as was true to her faith, and let that model do the reflection for her. I wanted to know what he/she looked like, wore, got around, and did for fun? She said that he wears Birkenstocks and rides a bicycle, and probably has flowers in his beard. She laughed and smiled; you could see the spiritual connection, strong in that moment. I asked about his personality – was he forgiving and kind or vengeful and smiting – as certainly both versions exist in Catholicism? She said “he is hip, but not a hipster.” I asked if he is with the times and gets what modern life is like, and she said he changes with the times. 
“So then, to him, does he get what dating is like?” She said he does.
“Does he think all first dates should be marriages?” She said he’d find that ridiculous, that you have to try people out for awhile to see what they are like and if they will be a good fit. “And if they are going to be a long-term good fit? Say, longer than the relationships you’ve had thus far? Even if it takes a few tries, even in your 40s?” She said he does.
“So you were guilty over what, again?” Nothing but smiles.

Autumn Hahn is a Licensed Mental Health Counselor and Certified Clinical Hypnotherapist practicing at Clear Mind Group in Florida and Georgia. Call 954-612-9553 for a consultation. Follow Autumn on Twitter & Facebook.